Less than a month into the academic year at Brophy College Preparatory in Phoenix, Alex, a 17-year-old high school senior, is feeling the strain of life in an uncertain time.
Growing up, he saw tests, grades and applications as part of a predictable, step-by-step process leading toward college. Not so much in a pandemic.
"All of that is sort of gone right now. You don't really know what to do next, and that's a big point of stress," he said. "It's really easy to feel isolated in terms of everything that's going on. You don't necessarily know where to turn."
Since the pandemic began, thousands of Arizona teens have turned to Teen Lifeline, a crisis line where Alex volunteers as a peer counselor. (Teen Lifeline volunteers use their first names only in the media to keep counselors anonymous.)
In an average year, calls and texts to the hotline decrease between 30% and 40% over the summer. Kids are simply less stressed during summer vacation. This year, summertime volume at the hotline went up by 6%, instead. A much higher proportion of the contacts have come in by text, as well. Many teens are stuck at home, without enough privacy from their families to make a confidential phone call.
Those numbers reflect a broader trend of elevated depression, anxiety and post-traumatic stress disorder among teens as they cope with the COVID-19 pandemic. Even before the pandemic, those issues were common in the United States, with more than 16% of youth dealing with a mental health disorder, according to a 2019 study published in JAMA Pediatrics.
And now, suicidal ideation is up among younger adults, found a recent study by the Centers for Disease Control and Prevention. Frequency of cannabis and alcohol use by teens has risen, according to one recent study in Canada, with solitary substance use becoming more common.
These changes come at a time when the mental health services provided by schools have been disrupted. In past years, more than a third of youth receiving mental health services in the U.S. got them in an academic setting. Experts believe that many of these youth are now going without the extra help.
With so many struggling, it's a vital time to offer support to teenagers in your life. Here's how to start, how to teach resilience and warning signs that might signal your teen needs extra help.
Follow your child's lead
Three years of volunteering with Teen Lifeline have taught Alex about the power of listening well. In fact, he doesn't even give advice — no one at the hotline does.
"We're here to mainly listen to callers, just have them feel heard," he said. "They want to be able to have the chance to talk about anything that's going on, with no repercussions."
That listening-first approach is the best way to learn what's happening in your teen's life, said psychologist Lisa Damour, whose podcast "Ask Lisa" covers the psychology of parenting, managing conflict and kids' distress at home in the pandemic and social development.
"The good news is teens usually take the lead," she said. Worried about how they're coping with school? Listen up. "They're very good at complaining about school under all conditions and letting us know what's not working. And that's just fine," Damour said.
As schools adjust to life in a pandemic, many new frustrations are cropping up, and Damour noted that it's important for teens to talk about what they're struggling with.
"One things parents can do is appreciate that just listening to the complaint, and not offering solutions or disagreeing, is a really valuable gift to give a young person," Damour said. "They just want someone to hear them out."
Focus on resilience
If you want to move the conversation beyond compassionate listening, psychologist Mary Alvord of Rockville, Maryland, suggested you bring up skills for building resilience and a sense of empowerment.
Alvord, who saw interest in resilience surge in the wake of the September 11, 2001, terrorist attacks, said those skills are especially relevant during a time of crisis. When starting a conversation with teens about resilience, Alvord asks them to sort through and categorize the issues they face.
"What can you control? What can't you control that you have to accept?" she said. In the pandemic, many things — including disrupted schooling, social unrest and the virus itself — are beyond individuals' control. Acknowledging it out loud can be a relief.
And resilience, Alvord said, is not just about tackling the big issues. When teens identify the things they can control in their lives, such as self-care and planning for the future, they build the skills of adapting to day-to-day challenges.
Some of the things we can control include taking care of our bodies and minds by getting plenty of sleep, eating well and incorporating physical activity into each day. When the usual means of socializing are off the table, teens can brainstorm novel ways to connect, whether they're virtual get-togethers or pandemic-safe outings.
And as scientists learn more about how COVID-19 works, it's clear that teens and adults worried about getting sick can protect themselves by wearing masks and maintaining physical distance. Not only is it the safest choice, but it can bring with it a bonus psychological payoff, as well.
"We know that people who don't take action start feeling helpless," Alvord said. "When you feel helpless, you're more prone to depression, and you're more prone to feeling like a victim."
Look for signs they might need more support
If your teenager feels irritable or down sometimes, it doesn't necessarily mean they need to see a mental health professional.
"Moods should come and go," Damour said. "It's perfectly fine for kids to feel bad or anxious for an afternoon or even a day. What we hope to see is that having become upset, or having experienced a painful feeling, kids work their way through it and they're able to move forward."
If you notice that they don't seem to snap back from a bad week, it could signal a more serious issue.
"It's time to worry when a young person seems stuck in an emotional rut and unable to feel better, or to move past whatever has made them upset," Damour said.
In addition to that, psychologist Alvord noted that sudden changes in behavior, such as moodiness or uncharacteristic irritability, can signal a mental health struggle. "Sometimes irritability in kids is actually an indication of depression," she said. "Sometimes it's an indication or real sadness."
In a normal time, isolation would be a signal, and Alvord pointed out that COVID-19 restrictions may mean some such signs are going overlooked.
"It's easier to isolate now," she said, noting that teens have less face-to-face access to teachers, religious leaders and other adults. Isolation is a norm. That places a greater burden on families to notice warning signs, said Alvord, even as they cope with their own stress and anxiety.
"A lot of it is on parents," she said, noting that in order to be available for teens, adults must also maintain their own well-being. "They have to take care of themselves so they can take care of their kids, too."
Tips to go
- Teens are struggling right now, with mental health issues and risky behaviors on the rise.
- Listening can help. Work on listening with an open mind, instead of offering solutions.
- Resilience is key to mental health in a time of crisis. Try starting conversations about the things teens can control even when life feels unpredictable.
- Watch for signs of a more serious issue, including bad moods your child can't seem to bounce back from.
- Model good self-care by taking care of yourself and making time for good sleep, healthy food and relaxation.